| Background And Objective: Among urinary system tumors in China, bladder cancer incidence ranks No. 1.About 70% ofthe initial issuance of bladder cancer is non-muscle invasive bladder cancer(NMIBC). The common surgical approach of NMIBC is transurethral resection of bladder tumor(TURBT), which has high postoperative recurrence rate.Benign prostatic hyperplasia(BPH) is the most common cause of the middle-aged and old male urination dysfunction, and it has higher incidence with age, about 50% at the age of 60, up to 83% at the age of 80.The common surgical procedure of BPH is transurethral transurethral resection(TUVP). What’s more, 7% of patients with bladder cancer are also withconcomitant BPH. BPH which leads to urinary tractobstruction is thought to be a risk factor for bladder cancer incidence. The surgical approach of NMIBC and BPHwhich have similar location is consistent, so they can be treated at the same time. Concurrent therapy will lead to large wounds exposition of bladder neck and prostatic urethra. In view of the characteristics of bladder tumor metastasis. There is no conclusion that concurrent therapy will increase the recurrence rate of bladder cancer.Therefore, the study of surgery on the same period NMIBC merge BPH patients after tumor recurrence rate and the impact on quality of life is particularly necessary.This study is to explore the feasibility and effecacy of transurethral resection of bladder tumor(TURBT) and transurethral transurethral resection(TUVP) on patients with non-muscle invasive bladder cancer(NMIBC) and benign prostatic hyperplasia(BPH),which offers guide for the linical treatment of bladder cancer patients with benign prostatic hyperplasia.Materials and Methods: The clinical date from 69 patients with NMIBC and BPH in the First Affiliated Hospital of Zhengzhou University from January 2012 to June 2015 were retrospectively analyzed. Among the 69 patients, 34 had simultaneously undergone TURBT and TUVP, and the rest 35 had undergone TURBT alone. between the two groups. By comparing the postoperative recurrence rate, the mean recurrence time, and so the number of cases of recurrent prostate fossa tumor recurrence and the operative time, blood loss, postoperative bladder irrigation time, postoperative hospital stay, postoperative complications perioperative outcome measures and study groups before and after surgery IPSS score, Qmax Qmax, residual urine volume and other changes, we envaluated efficacy and safety of the treatment on patients with bladder cancer with benign prostatic hyperplasia.Results: Two groups of operations were successful.In the study group, 5 cases of recurrence, the recurrence rate was 14.70 percent, the average time was 16.80 month. In the control group,4 cases of recurrence, the recurrence rate was 11.42%, the average recurrence time was 17.25 month. During follow-up time of both groups, cases of prostate fossa metastasis were not found.The difference of recurrence rate and time of recurrence was not statistically significant(P> 0.05).The mean operation time of Study Group was 51.28±17.80min; the average blood loss 74.26±26.73ml; bladder washing time 4.63±1.56d; postoperative hospital stay was 6.75±1.43 d. The mean operation time of Control Group was 26.72±12.37min; bleeding volume average 21.70±10.28ml; bladder washing time average 3.12±1.13d; postoperative hospital stay was 6.49±1.55 d. Compared with the control group, the study group operative time longer, the average amount of bleeding more, the average bladder flushing longer,(P <0.05). The postoperative hospital stay is equivalent to the difference was not statistically significant(P> 0.05).Study Group 1 case of transient stress urinary incontinence, pelvic floor muscle training and after application of bladder relaxants week fully improved. Temporary stress urinary incontinence occurred in 1 cases in study group and the within 1 week after pelvic floor muscle training and application of bladder relaxants get fully improved. 1 cases of postoperative bladder bleeding, 1 cases of bladder neck contracture. A total of 3 patients(8.82%). Control group of 1 cases of postoperative urethral stricture, urethral stricture after transurethral resection of the normal urination, 2 cases of postoperative urinary bladder bleeding, give symptomatic treatment after the improvement. A total of 3 patients(8.57%). No two bladder perforation, transurethral resection syndrome and other complications. The incidence of complications between the two groups was not statistically significant(P> 0.05).Preoperative study group IPSS score was 21.25±5.58 points, Qmax average 7.83±2.65ml/s, residual urine volume average76.3±28.2ml.Postoperative IPSS score was 6.35±3.27 points, Qmax average 18.61±7.37ml/s, residual urine volume average 16.72 ± 2.23 ml. Compared with the Qmax, RUV, IPSS, etc of the preoperative, the data of Postoperative improved than before, and the difference was statistically significant(P <0.05).Conclusion: 1 Compared with TURBT alone, simultaneous TURBT and TUVP do not increase the recurrence rate of bladder cancer and the risk of prostate cancer metastasis to the urethra,. At the same time, simultaneous TURBT and TUVP can relieve the symptoms of lower urinary tract obstruction of patients, improve the quality of life of patients.Earlier surgery is effective and reliable, so that patients can advoid the second surgery of the pain, which also can reduce the economic pressure of patients. 2 Compared with TURBT alone, the postoperative hospital stay of simultaneous TURBT and TUVP does not increase,the risk of postoperative complications dose not increase, however, the surgery prolonges, blood loss increases and the postoperative bladder irrigation prolonges. |
PDF Full Text Request